hips and abdomen by straightening the back. This will cause the head to be lower than the lungs and the water will run out of the mouth (fig. 319). Hold in this position for a few moments, or as long as the water runs out of the mouth, giving the body several slight shakes. Then sweep the finger into the mouth to see that the throat is not clogged with sand, seaweed, or other matter, remove tight clothing from around the neck or throat and begin artificial respiration immediately. It is not necessary to roll an apparently drowned person over a barrel to get the water out of him. Attempts at resuscitation on a beach should not be made with the part of the body submerged in the water or in such a position that a wave may sweep over the unconscious person. It is better to drag him well up where he will be dry and out of danger.

Artificial respiration on apparently drowning persons should be carried out as directed on page 277. As soon as the person is revived and the breathing is satisfactory, he should be taken to some warm place, the extremities rubbed, and suitable general remedies administered.

ELECTRIC SHOCK.

Many of the wires strung about city streets carry powerful electric currents. If such wires become broken or sag down, passers-by may come in contact with them and receive severe and possibly deathdealing shocks.

Prevention.-Broken wires of any sort dangling from their poles should not be touched. They may carry dangerous currents themselves or be temporarily charged, because they are somewhere resting on live wires.

Symptoms. In severe electric shock there is sudden loss of consciousness, the breathing is apt to be entirely arrested, and the pulse weak. Burns may be caused by the arcing of the current where the wire has touched the body.

Treatment.—The first thing to be done is to break the contact of the person with the wire or third rail; great care must be exercised in doing this or the helper may be as badly injured as the original victim. The body of a person lying upon a conductor is fully charged with the electricity, and it is dangerous to touch it with bare hands unless the body of the assistant is thoroughly insulated. The coat, however, may be grasped, and possibly the injured person can be dragged from the wire in this manner without actually touching the flesh. If absolutely necessary to take hold of the body, wrap the hands in several thicknesses of dry cloth, rubber sheeting, or dry newspapers, and stand on a dry board or other nonconductor if possible.

A live wire may be removed from an unconscious person by lifting it off with a dry pole, wooden walking stick, or some similar article

HOW TO RESCUE PERSON FROM CONTACT WITH ELECTRIC CURRENT
(When possible the rescuers should Stand on Dry Wood or Cloth)

FIG. 320.-Electric shock. (Courtesy American Red Cross.)

made of wood, which is a nonconductor. The wood must be dry, however. The person endeavoring to perform the rescue should in

all cases stand on a dry board if it is obtainable. A number of newspapers, or the operator's folded coat will answer the same purpose in an emergency. Rubber overshoes and heavy rubber gloves furnish good protection. If the powerhouse is near or there is a switch in the locality, it may be better to attempt to have the current turned off rather than to try other procedures. If the live wire is so twisted around the body that it is necessary to cut it, use an ax or hatchet with a wooden handle. Be careful that the cut end does not strike the operator.

When a wire is taken off the body or a person removed from the wire, this should be done with one motion if possible, because if the wire touches the person several times burns will be received at each contact.

After the person has been removed from the current, if he is not breathing, artificial respiration should be immediately performed followed by the usual restorative measures as described on page 277. For the treatment of burns from electric wires, see page 273.

GAS POISONING.

Gas poisoning is a frequent accident, especially in the larger cities and towns where gas is used for illumination purposes. Various gases may be detrimental when inhaled for a considerable period, the amount of injury depending upon the nature of the substance, and even apparently innocuous gases, such as carbon dioxide, may cause death, not by their direct action but by depriving the patient of air because they have replaced it, and the patient is not getting oxygen. Gases like ammonia or chlorine may quickly produce death from shock and irritation. Recently deaths have been reported from the gas generated by an automobile engine running in a small garage which was tightly closed on a cold morning. The use of poisonous and irritating gases in warfare has been developed to a great degree in the present European war.

Firemen are frequently overcome from the effects of smoke and the products of combustion from wood, varnish, and other materials in burning buildings.

By far the greater number of cases of suffocation due to gas in this country are caused by illuminating gas. Many persons use this method of committing suicide.

Prevention. A gas burner should never be turned down low and allowed to burn all night in a room in which persons are sleeping, as the flame may be extinguished by a change in pressure or a slight draft and later the room become filled with gas. When going into burning buildings which are filled with smoke it is well to tie a cloth wet with water around the nose and mouth. As the air is generally purer near the floor than at the ceiling, the person should,

if necessary, walk on the hands and knees or crawl on the floor. In entering a room or other place which is full of gas to remove a suffocated person take several deep breaths of pure air outside and spend as brief a time in the compartment as possible.

Symptoms of illuminating-gas suffocation.-Preliminary signs are headache, dizziness, nausea, feeling of sleepiness and langour, and a rapid pulse. In later stages when unconsciousness comes on, the face and hands are blue, heart action is very rapid and weak, and breathing may be shallow or entirely suspended.

Treatment.—The patient should always be immediately removed to where the air is fresh and good. If he is only slightly affected, walk him up and down in the open air and give some effervescing drink, such as soda water, Weiss beer, or a teaspoonful of baking soda in a glass of water. This will cause belching of the gas and relief from nausea.

In more severe cases, when the patient is more or less unconscious but still breathing, sprinkle a few drops of ammonia water on a handkerchief and allow the patient to take one breath with this under his nose, once a minute. Rub the arms and legs briskly toward the heart to promote the circulation. If the patient is conscious enough to swallow, give one-half teaspoonful of aromatic spirits of ammonia in half a glass of water.

If breathing has ceased, begin artificial respiration at once, after loosening the collar or any tight clothing around the neck and chest. Have an assistant give whiffs of ammonia, as described above, and also rub the extremities toward the heart; but do not let these procedures interfere with the artificial respiration, which must be continued without interruption until the patient begins to breathe of his own accord in a regular manner.

The after treatment is rest in bed with appropriate stimulation. In severe cases the patient should be kept in bed until he has fully recovered, as dangerous symptoms have followed getting up too early.

STRANGULATION AND HANGING.

Treatment.-Remove the cause immediately. In cutting down a person who has attempted to commit suicide by hanging, hold the body in such a way that he will not be injured by the fall. Remove the noose and then immediately proceed to perform artificial respiration. The after treatment is the same as for other cases of suffocation.

UNCONSCIOUSNESS.

Description.-A person is unconscious when he does not realize what is going on around him. Unconsciousness may be complete or partial. In the latter case the individual can be aroused, but is not fully in the possession of his senses.

Causes of unconsciousness.-All forms of unconsciousness are due to a disturbance of the brain of some sort. The causes which act on the brain and produce this condition are many and varied. A blow on the head or pressure on the brain from a large blood clot or a depressed fracture of the skull may cause unconsciousness. A lack of blood supply to the brain produces the same condition as in fainting. Certain drugs, like opium, ether, chloroform, or large amounts of alcohol when circulating in the blood affect the brain and are followed by loss of consciousness. Such substances may be absorbed from the stomach or inhaled and taken up by the lungs. The system itself may produce poisons which are not gotten rid of and unconconsciousness follows. This frequently occurs before death from diabetes. Finally, unconsciousness may be a symptom indicating a disease of the nervous system, such as epilepsy.

An unconscious person is absolutely helpless and especially dependent on his friends or whoever happens to be near for aid and protection from harm. However, a word of warning concerning the handling of unknown unconscious individuals in public places may not be amiss. It is not wise to follow a perfectly natural impulse to search the clothing or to look through the pocketbook of an unconscious person to ascertain his name and address. Such an act may be interpreted by the bystanders as an attempt at robbery, and unpleasant complications result. These measures should be left to the police or other persons of recognized authority.

GENERAL RULES FOR THE EXAMINATION OF UNCONSCIOUS

PERSONS.

1. Feel the pulse at the wrist and form an estimate of its rate and force. A rapid, weak pulse indicates a dangerous condition. A strong pulse, beating between 76 and 90, is a good sign.

2. Determine whether the person is breathing or not and the nature of the respirations; whether they are slow or fast, deep or shallow. 3. Note the color of the face.

4. Observe if the skin is hot or cold and the presence or absence of perspiration.

5. Examine the eyes to see if the pupils or black spots in the middle of the eye are small or large (figs. 322 and 323). Compare the two eyes to see if the pupils are of the same size (fig. 324).

6. If the person has evidently been the victim of an accident, look for hemorrhage and feel the head to detect possible fractures of the skull.

7. Take into consideration the surroundings and other general conditions. When the heat is excessive, heat strokes are a common cause of unconsciousness. An empty bottle near by may suggest attempted suicide by poisoning. Signs of a struggle might indicate an assault with brain injury.